Ultrasonography for meniscal injuries in knee joint: a systematic review and meta-analysis

INTRODUCTION: The aim of the paper is to systematically review the diagnostic accuracy of ultrasonography for meniscal injuries in knee joint.EVIDENCE ACQUISITION: A search of PubMed and Web of Science was performed up to January 2015. Only studies for diagnosis meniscal injuries by ultrasonography were included. The results were meta-analyzed by pooling estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and constructing the summary receiver operating characteristic (SROC) curves.EVIDENCE SYNTHESIS: Twenty-one studies met the selection criteria for inclusion in the analysis. The pooled estimates for sensitivity, specificity, and area under curve (AUC) of ultrasonography diagnosis were 0.775 (95% CI: 0.747-0.801), 0.838 (95% CI: 0.818-0.857), and 0.9107 (95% CI: 0.8625-0.9589), respectively. For lateral meniscus diagnosis and medial meniscus diagnosis, the AUC was 0.9812 (95% CI: 0.9592-1.000) and 0.8997 (95% CI: 0.7313-1.000), respectively. However, in diagnosis by magnetic resonance imaging (MRI), the AUC was 0.9421 (95% CI: 0.8760-1.000). The ultrasonography inter-observer agreement resulted in a moderate reliability, with the κ value ranged from 0.381 to 0.482.CONCLUSIONS: We found the diagnostic accuracy of ultrasonography for meniscal injuries was good. No evidence showed MRI had better accuracy than ultrasonography diagnosis. We recommend ultrasonography should be routinely used for evaluation of meniscal injuries in knee joint.